Recently, nine-year-old Jay was rough-housing with a group of teammates during a sporting event when the playful scenario transformed into a temper-flared name calling match, as sometimes happens in childhood. As the group dispersed, one last taunt was yelled to the only African-American teammate in the group, “At least we’re not black!” On the way home from the event, Jay asked his mother why being black is a bad thing. A jumble of thoughts rushed to her mind as she fumbled to respond. Later, putting on her professional ‘hat,’ as a maternal and child health professional, she wondered if this experience would become one of many small, but subtly cumulative social experiences that could over a lifetime in influence on her son’s health and well-being – part of the complex myriad of factors that make up the social determinants of health.

We have long understood the lasting impact that childhood experiences have on the mental and physical well-being of children, and we are learning more and more about how much the person we become is shaped by our environment, not just our genes. In fact, science is now beginning to show that our early experiences can actually impact how our brains develop. In the December 5 Altarum Health Policy Form, Sarah Lifsey discussed the link between Adverse Childhood Experiences (ACE) and a host of risk factors and negative health outcomes. She also pointed to some of the science that demonstrates how these negative experiences and toxic stress lead to changes in the brain and impact the parts of the brain responsible for learning, memory, decision-making, and anxiety. She stressed the value of integrating socio-emotional development and mental health support into the systems that support young children and their parents. Racism is among those early childhood stressors that continue to be a factor shaping early experiences and thus the future of our children. According to the recent Altarum report, The Business Case for Racial Equity:

“Racism in the U.S. has left a legacy of inequities in health, education, housing, employment, income, wealth, and other areas that impact achievement and quality of life. Opportunities that were denied to racial and ethnic minorities at critical points in the nation’s history have led to the disadvantaged circumstances that too many children of color are born into today.”

The authors go on to describe the impact that social and economic factors have on individual and societal well-being: “The social and economic forces that influence opportunities for achievement are interconnected and reinforcing. Healthier, better-educated people tend to earn more and live in higher-income neighborhoods, where they experience lower crime rates, less pollution, better quality education and community amenities, and have more resources to stay healthy.”

Altarum recently joined over 100 other organizations that are supporting the upcoming project, The Raising of America: Early Childhood and the Future of Our Nation, which was recently previewed at the American Public Health Association (APHA) Annual Meeting and will air on PBS in 2014. The project and accompanying documentary will examine early childhood health and development and how investment in early childhood can contribute to better outcomes (physical, economic, health and mental health) over the course of a child’s life. This is consistent with one of the conclusions from the Business Case – that now is the time to invest in our future by investing in our youngest generation.

In the coming decades, it is today’s younger generation who will drive economic growth, whose tax contributions will support social insurance programs for the elderly and other services, whose purchasing power will determine the demand for goods and services, who will serve in our armed forces, and who will act as caregivers to an aging population. The majority of this generation will be children of color, many of whom will face the legacy effects of past racism and ongoing inequities of structural racism and implicit biases touched upon in this brief. The ability of these children to succeed will shape our shared future.

Altarum has a long­standing commitment to addressing both the early childhood experience and racial and health equity through a systems approach to improving health and well-being. From our work with the Kellogg Foundation in developing the business case to our strategic support for the National Partnership for Action to End Health Disparities, we understand the complexities associated with race, disparities, and other social determinants of health. We have been engaged in multiple projects aimed at creating and evaluating an effective system of resources and services for children ages 0 to 5 and their families.

Our findings from Altarum led evaluations of programs, like the Early Childhood Comprehensive Systems, as well as the Bright Future Initiative, and Smart Beginnings Coalitions in collaboration with the Virginia Early Childhood Foundation, have recognized and applauded the progress of efforts to strengthen early childhood services, but they have also shown that there is a long way to go to ensure that this outcome is realized for as many children as possible.

We look forward to the opportunity to continue our work in these complex arenas while also contributing to the dialogue as a partner in the National Public Awareness Campaign for the Raising of America project. We are proud to deepen our commitment to early childhood and health equity by joining in this effort with more than 100 national and regional organizations working to build a more equitable and supportive world for Jay and all children.